Photo: Elephant’s Head from Thuchila Hut, Mulanje
3 April 2017
I texted Sterra (actually, Stella) this morning at the Chileka District Health Center, saying I’d be coming to try to interview—let’s call her Angela Kolumba—in Mdala village today. I didn’t hear back so biked up to Queens to meet Maurice, my amiable interpreter, at the Peds Mental Health Clinic at 8:30AM. We walked together to the minibus stop and took one for Chirembe. However, leaving the Blantyre boma (downtown) we were pulled over at a police stop. A stunningly-attractive policewoman sauntered languorously around the car, steely eyes missing nothing, saw that the minibus sticker on the windshield had expired and wrote out a ticket. Appeasement and bribery didn’t work, so the driver got out and walked off in a huff, up the block and across the road to disappear into a group of shops. So did the assistant. I offered to drive but thought better of it. Finally, the ticket was completed, the driver returned, and we set off again. This was a particularly beat-up minibus and the driver shut off the engine on every downgrade to save petrol. We finally arrived at Chirembe and transferred to another minibus for Chileka. There were never more than 15 people in the van, which was remarkable.
At the Chileka District Health Center we disembarked and quickly found ourselves in the well-baby clinic, surrounded by women of all ages wrapped in colorful chithenje’s with another tied around their shoulders and chest, holding their infants snugly to their backs. We found Stella; she is the Health Surveillance Assistant supervisor, a tough but appealing woman who quickly summoned Chrissy for us. Chrissy is the HSA for Mdala, a village of 4,700 people. Since it was her home and childhood village, she knew Angela Kolumba and knew precisely where she lived.
So we backtracked a few kilometers by minibus to the road into the “village”, which is actually many huts planted on the hillsides stretching into the distance for kilometers. We then hired a “taxi”—the worst minibus I’ve been in, with a plywood floor, seat benches not bolted to the floor, a non-functional battery and starter motor, no shock absorbers, etc.—for MWK3000 each way. The driver was a businessman, informing us along the way that the last steep bit would cost another MWK500. It is an overstatement to call what we drove on a road and my admiration for the capabilities of these ancient Toyota beater-vans rises up several notches. This driver, as well, tried to save petrol by shutting off the motor on the downgrades, meaning no power brakes or steering, and jumpstarting the car just before the upgrades.
Once the taxi was parked, we walked up a dirt path between houses and maize fields, past children playing and housewives washing clothing, to a tiny mud-brick house with a covered verandah. A petite woman, sturdy and friendly, came out in response to Chrissy’s “Odi?” (Anybody in there?). Chrissy explained who we were and why we were there—-a doctor from the College of Medicine to interview her about her recent illness (Donkin or eclampsia-without-seizures psychosis) so he can teach other doctors how to treat it properly. She graciously accepted the package of biscuits, liter of cooking oil, and bar of soap I gave her, “God bless you for your gifts.” Then she brought a small stool from the house for me to sit upon, the plastic case for a car battery for her to perch on, and Maurice and Chrissy sat on a rock wall while we talked.
She didn’t recall a lot about her illness, saying that her legs had been swollen and that she was confused and scared. She denied hearing voices or refusing to drink or eat, as her relatives had stated, although she said she couldn’t swallow porridge one morning. Her father died two years ago, her mother lives many km away in Zomba, she never went to school, and she didn’t know what year it was. But she knew her village, the season, and the names of her neighbors, all information more important to her life as a farmer than the date. Her 6yo son was with us and she was very affectionate with him. The baby was down the hill at a neighbor’s for the morning. She told a life story of moving from place to place, never attending school or learning to read, not knowing her date of birth, and of extreme poverty. She was clearly kind and gracious and totally sane. We took some photos of us all and left after an hour. She must have thought we dropped in from outer space. Clearly a mzungu (European—white person) had not hiked through this village in a long time.
The taxi awaited us for the trip back. It was much as the trip up, except that at one point the driver had words with a young man walking along the road. He stopped the van, pulled out a long machete from behind his seat, and waving it set off across an open pasture after the other man. Needless to say, the other fled into the woods. Warm Heart of Africa, eh? I asked Maurice, “What was that about?” “They had a disagreement.” Quite. Or as the Malawians might say, “Is it?”
Chrissy headed back to the Clinic and Maurice and I jumped a minibus for Limbe, to drop us off at Ginnery Corner by Queens. I suspect there was a distillery or a “gin mill” there at one time. A preacher in a bright red shirt with white polka dots and a 2” wide black leather belt that nearly encircled his waist twice was determined to chat me up. So we talked a lot until it finally came out I was a psychiatrist teaching at the College of Medicine, at which point his fire cooled a bit and he took up chatting with Maurice. There was a pretty mzungu girl with long blond hair and tattoos on her left calf sitting next to Maurice and the preacher assumed she and I were together. (I likely could have been her great-grandfather.) She exited shortly. We did soon after, I thanked Maurice and gave him some Kwatcha for his time and biked to Flavors for lunch.
The most remarkable aspect of this entire thing is how seamlessly it has unfolded. By some miracle I found the perinatal file and the file from the subsequent admission when Angela was psychotic easily, despite no systematic or centralized records in this huge hospital. I found Stella who found Chrissy who knew Angela who happened to be home when we turned up in our “taxi”, which is a total anomaly to find in a little village. And Angela was cooperative. And we got home without a minibus accident. Only one ticket and a machete chase. Just a day in the life of an academic (now) psychiatrist. I’ll write the paper and my guess is, since it will be the first case reported from Africa, it’ll get published easily. What a lark. Pad my CV! Who will read the CV or care? Nor do I!
I’m thinking about Benjamin Franklin, Andre Ampere, Michael Faraday, George Ohm, and Thomas Edison. The breaker panel is fried in the Pediatric Mental Health Clinic at Queens, so I have no lights in my office there. Many of our friends have been experiencing power cuts, often for several days, despite the abundant rain and consequent flows in the Shire River which powers the main turbines for the country. Puzzling. The first floor hallway of my office building at the College of Medicine has 17 ceiling lights. 10 are not working, one is flashing, and the other 6 have half a cupful of dead insects in the bottom of the glass light cover, absorbing much of the light from the fluorescent bulbs. I note that there are no lights, or light fixtures, in the Men’s Bathroom, despite a 5 foot long urinal trough, two toilets (neither of which flush), two sinks and a non-functional electric hot air hand drier. I guess no one is expected to use the toilets after dark (about 6:15PM). The sub-text is, “We don’t encouraged you to work long hours here.” Infrastructure. “Towards electricity all day, every day” seems out of reach.
In closing, I have noted new wildlife in the yard. A Brimstone Canary and a group of 4 Mousebirds were zipping through the bushes. We have skinks (a kind of lizard) with iridescent blue and green striped tails. Stunning. We had an infestation of flies the other day and Chimwemwe, our gardener, noted that the sewerage outflow was plugged. That was quickly remedied by George (no relationship) Fixit, as our landlady calls him. And he can. I digress. Flies aren’t really wildlife, true enough. I saw a group of 6 or 7 Pied Crows in the front yard two days ago. They were approaching the front terrace and generally acting in a curious way. When I peered through the front screen door, there was a large mongoose perched in the raised planter 3 feet from me. Did I jump? Yes! Google Image mongoose and you will see astounding pairings of them with cobras. I tremble merely looking at the images, several iterations removed from the real action. Oh, and the Southern (Lesser) Double Collared Sunbird pair were back in the yard. Our friends have the most amazing spider—a massive, beautiful, Golden Orb Weaver. They catch and eat small birds, as well as insects. Their webs are golden in the sunlight. And they are substantial, with gold filigree on their bodies and red legs. Make a circle with your thumb and first finger—the body is about that size. And the web wasn’t bothered by the terrific torrential downpour night before last.
We’ll hike up onto Mulanje for 4 days next (Easter) weekend. With a guide and 3 porters for 4 of us. Whiskey in Linda’s cocoa before bed is a peak experience! And perhaps some Pounce or Nertz or whatever you call that intensely competitive, trash-talking card game.